title: Use of noninvasive gas exchange to track pulmonary vascular responses to exercise in heart failure.
abstract: We determined whether a non-invasive gas exchange based estimate of pulmonary vascular (PV) capacitance [PVCAP = stroke volume (SV) × pulmonary arterial pressure (Ppa)] (GXCAP) tracked the PV response to exercise in heart-failure (HF) patients. Pulmonary wedge pressure (Ppw), Ppa, PV resistance (PVR), and gas exchange were measured simultaneously during cycle exercise in 42 HF patients undergoing right-heart catheterization. During exercise, PETCO2 and VE/VCO2 were related to each other (r = -0.93, P < 0.01) and similarly related to mean Ppa (mPpa) (r = -0.39 and 0.36; P < 0.05); PETCO2 was subsequently used as a metric of mPpa. Oxygen pulse (O2 pulse) tracked the SV response to exercise (r = 0.91, P < 0.01). Thus, GXCAP was calculated as O2 pulse × PETCO2. During exercise, invasively determined PVCAP and non-invasive GXCAP were related (r = 0.86, P < 0.01), and GXCAP correlated with mPpa and PVR (r = -0.46 and -0.54; P < 0.01). In conclusion, noninvasive gas exchange measures may represent a simple way to track the PV response to exercise in HF.
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Taylor
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Olson
authors.lastname: Chul-Ho-Kim
authors.forename: Dean
authors.initials: D
authors.lastname: Maccarter
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Johnson
keywords: capacitance; exercise; gas exchange; pulmonary vasculature; vasculature